NDLI: Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis

Content Provider	Springer Nature : BioMed Central
Author	Lawson, Mackenzie Apps, Helen Ramaphane, Peggie Barchi, Francis
Abstract	Background Research examining young people’s healthcare-seeking behaviors in Sub-Saharan Africa has largely focused on university or out-of-school youth who are sexually active and/or HIV-positive. Healthcare-seeking behavior in younger adolescents has been less well studied even though it is during secondary school years that the majority of adolescents become sexually active. There is limited evidence to guide strategies that schools, health facilities, and social service agencies use to encourage adolescents to utilize sexual and reproductive health resources prior to sexual debut. Methods This study used cross-sectional data collected in 2021 during school hours from eleven secondary schools in the Northwest District of Botswana. Adolescents ages 14–19 years completed surveys using hand-held tablets. Descriptive statistics were run for all variables; bivariate analyses examined their association with skipped visits. Logistic regression identified correlates of forgone visits. The outcome variable of interest was whether a respondent had ever forgone a visit to a health clinic for sexual and reproductive health information or services. Results 553 adolescents, provided information used for analysis. One fifth of respondents had had sexual intercourse (21%). Most had not been tested for HIV (54%), did not know their HIV status (60%), or had not had an STI other than HIV (92%). Teachers (31%) and female family members (31%) were the most frequently consulted sources on bodily changes during adolescence. In the bivariate analysis, age, gender, sexual experience, HIV testing, awareness of HIV status, and having had an STI were significantly associated with forgone visits. At the multivariate level, younger respondents and those who had never been tested for HIV or had an STI had lower odds of forgone visits compared to their older peers and those who had been tested or had an STI. The most common reasons for forgoing visits reflected perceptions that nurses were unfriendly and did not believe adolescents should have sex. Students identified logistical barriers, including not knowing where to go, long distances to services, and limited operating hours. Conclusions While logistical barriers might be easily addressed, perceived barriers, including negative staff attitudes and behaviors towards adolescents, require concerted and collaborative efforts by educators, health professionals, and policy makers to change.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-21629-3.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-025-21629-3
Journal	BMC Public Health
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-02-05
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Health-seeking Healthcare-seeking Africa Adolescents Sexual and reproductive health Stigma Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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